title: [Association between urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery].
abstract: OBJECTIVE
  To test the hypothesis that Neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for acute kidney injury (AKI) in patients after cardiac surgery.
  
  
  METHODS
  33 cases undergoing cardiac surgery were divided into AKI group and Non-AKI group according to the AKI criteria. The concentration of urine NGAL at different time points were measured.
  
  
  RESULTS
  (1) Nine of 33 cases (27%) developed postoperative AKI, but diagnosis with serum creatinine was only 12-48 hours after cardiac surgery. (2)Urinary concentrations of NGAL at 2 h after cardiac surgery in patients who did not developed AKI were significantly higher compared with those of preoperative (P < 0.001). Urinary concentrations of NGAL at 2 h and 4 h after cardiac surgery in patients who developed AKI were significantly higher compared with those of preoperative (P < 0.001). (3) The mean urinary NGAL concentrations in patients who developed AKI were significantly higher after surgery compared with patients who did not develop AKI (P < 0.01). (4) Urinary concentrations of NGAL/Ucr at 2 h and 4 h after cardiac surgery in patients who did not developed AKI were significantly higher compared with those of preoperative (P < 0.05). Urinary concentrations of NGAL/Ucr at 2 h and 4 h after cardiac surgery in patients who developed AKI were significantly higher compared with those of preoperative (P < 0.01). (The mean urinary concentrations of NGAL/Ucr in patients who developed AKI were significantly higher after surgery compared with patients who did not develop AKI (P < 0.01). (6) For concentrations in urine of NGAL at 2 h after surgery, sensitivity was 0.7125, and specificity was 0.7307 for a cutoff value of 250 microg/L. For concentrations in urine of NGAL/Ucr at 2 h after surgery, sensitivity was 0.8127, and specificity was 0.7839 for a cutoff value of 250 microg/mmol. (7) Urinary concentrations of NGAL at 2 h after cardiac surgery was significantly associated with serum creatinine 12 h postoperative (R = 0.638, P < 0.05).
  
  
  CONCLUSIONS
  The incidence of AKI in patients after cardiac surgery is high, which accounted for 27%. The amount of NGAL and NGAL/Ucr in urine at 2 h after cardiac surgery were the powerful independent predictor of acute renal injury and urine concentrations of NGAL/Ucr is more sensitive.
authors.affiliation: Department of Nephrology Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wan
authors.forename: Chang-chun
authors.initials: CC
authors.lastname: Cao
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Yu-long
authors.initials: YL
authors.lastname: Xiao
authors.forename: Wen-fang
authors.initials: WF
authors.lastname: Wu
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Xin-wei
authors.initials: XW
authors.lastname: Mu
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000652:urine; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000652:urine*; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine